Ch. 21, Assessment of Respiratory Function. Study Guide Questions.
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| The purpose of the cilia is: | move mucus back to the larynx.
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| A patient with sinus congestion points to the area on the inside of the eye as a point of pain. The patient is referring to which sinus? | ethmoidal
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| The lungs are enclosed in a serous membrane called the: | pleura.
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| The left lung, in contrast to the right lung, has: | one less lobe.
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| The divisions of the lung lobe proceed in the following order, beginning at the mainstem bronchi: | lobar bronchi, segmented bronchi, subsegmented bronchi, bronchioles.
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| Name the initial part of the respiratory tract that is not considered part of the gas-exchange airways. | bronchioles
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| Name the alveolar cells that secrete surfactant. | Type II cells
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| Gas exchange between the lungs and blood and between the blood and tissues is called: | respiration.
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| The maximum volume of air that can be inhaled after a normal inhalation is known as: | expiratory reserve volume.
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| Tidal volume, which may not significantly change with disease, has a normal value of approximately: | 1,000 mL.
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| The exchange of oxygen and carbon dioxide from the alveoli into the blood occurs by: | diffusion.
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| Airflow into the lungs during inspiration depends on: | 1) enlargement of the thoracic cavity; 2) lowered intrathoracic pressure; 3) relaxation of the diaphragm.
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| The pulmonary circulation is considered a: | high-pressure, high-resistance system.
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| Gerontologic considerations in the respiratory system include: | 1) decreased gag reflex; 2) increased presence of collagen in alveolar walls; 3) decreased presence of mucus.
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| The symbol used to identify the partial pressure of oxygen is: | PAO2.
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| Uneven perfusion of the lung is primarily due to: | 1) pulmonary artery pressure; 2) gravity; 3) alveolar pressure.
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| A nurse caring for a patient with a pulmonary embolism understands that a high ventilation-perfusion ratio may exist. This means that: | ventilation exceeds perfusion.
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| A nurse understands that a safe but low level of oxygen saturation provides for adequate tissue saturation but allows no reserve for situations that threaten ventilation. A safe but low oxygen saturation level is: | 40 mm Hg.
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| When taking a respiratory history, the nurse should assess: | 1) the previous history of lung disease in the patient or family; 2) occupational and environmental influences; 3) smoking and exposure to allergies.
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| Bacterial pneumonia can be indicated by the presence of: | 1) green, purulent sputum; 2) thick, yellow sputum; 3) rusty sputum.
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| Nursing assessment for a patient with chest pain includes: | 1) determining whether there is a relationship between the pain and the patient's posture; 2) evaluating the effect of the phases of respiration on the pain; 3) looking for factors that precipitate the pain.
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| Chest pain described as knifelike on inspiration would most likely be diagnostic of: | pleurisy.
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| Hemoptysis, a symotom of cardiopulmonary disorders, is characterized by: | 1) an alkaline pH; 2) a sudden onset; 3) bright red bleeding mixed with sputum.
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| A patient exhibits cyanosis when how much hemoglobin is unoxygenated? | 5.0 g/dL
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| The nurse inspects the thorax of a patient with advanced emphysema. The nurse expects chest configuration change consistent with a deformity known as: | barrel chest.
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| Breath sounds that originate in the smaller bronchi and bronchioles and are high-pitched, sibilant, and musical are called: | wheezes.
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| Crackles, noncontiguous breath sounds, would be assessed for a patient with: | collapsed alveoli.
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| During a preadmission assessment, the nurse would expect to find decreased tactile fremitus and hyperresonant percussion sounds with a diagnosis of: | emphysema.
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| The arterial blood gas measurment that best reflects the adequacy of alveolar ventilation is the: | PaCO2.
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| Nursing directions to a patient from whom a sputum specimen is to be obtained should include directing the patient to: | 1) initially clear his/her nose and throat; 2) take a few deep breaths before coughing; 3) use diaphragmatic contractions to aid in the expulsion of sputum.
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| A physician wants to study a diaphragmatic motion because of suspected pathology. The physician will most likely order a: | fluroscopy.
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| Nursing instructions for a patient who is scheduled for a perfusion lung scan should include informing the patient that: | 1) a mask will be placed over his/her nose and mouth during the test; 2) he/she will be expected to lie under the camera; 3) the imaging time will amount to 20-40 minutes.
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| The nurse should advise a patient who is scheduled for bronchoscopy that he or she will: | 1) have his/her nose sprayed with a topical anesthetic; 2) be required to fast before the procedure; 3) receive preoperative medication.
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| Distinguish between the terms "ventilation" and "respiration." | Ventilation refers to the movement of air in and out of the airways, whereas respiration refers to the gas exchange between atmospheric air and blood and between the blood and the cells of the body.
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| Describe the function of the epiglottis. | The epiglottis is a flap of cartilage that covers the opening of the larynx during swallowing.
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| List conditions that cause low compliance or distensibility of the lungs. | morbid obesity, atelectasis, pneumothorax, hemothorax, pulmonary fibrosis or edema, pleural effusion, ARDS
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| Define the term "partial pressure." | pressure exerted by each type of gas (e.g., oxygen, carbon dioxide) in a mixture of gases
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| Name two centers in the brain that are responsible for the neurologic control of ventilation. | the apneustic center in the lower pons; pneumotaxic center in the upper pons
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| List six major signs and symptoms of respiratory disease. | dyspnea, cough, sputum production, chest pain, wheezing, hemoptysis
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| List four conditions that are influenced by genetic factors that affect respiratory function. | asthma, COPD, cystic fibrosis, alpha-1 antitrypsin deficiency
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| Explain the breathing pattern characterized as Cheyne-Stokes respirations. | alternating episodes of apnea (cessation of breathing) and periods of deep breathing; usually associated with heart failure and damage to the respiratory center
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| When a bronchoscopy is ordered, the nurse knows that the suspected lesion was not in the: | pharynx.
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| Nursing measures before bronchoscopy include: | 1) obtaining an informed consent; 2) supplying information about the proedure; 3) withholding food and fluids for 6 hours before.
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| The nurse is aware that possible complications of bronchoscopy include: | 1) aspiration; 2) infection; 3) pneumothorax.
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| After a bronchoscopy, the patient must be observed for: | 1) dyspnea; 2) hemoptysis; 3) tachycardia.
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| After a bronchoscopy, the patient can be given ice chips and fluids after he/she: | demonstrates that he/she can perform the gag reflex.
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| Nursing responsibilities before a thoracentesis include: | 1) informing the patient about pressure sensations that will be experienced during the procedure; 2) making sure that chest roentgenograms ordered in advance have been completed; 3) seeing that the consent form has been explained and signed.
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| For a thoracentesis, the patient is assisted to one of the following positions: | 1) lying in the inaffected side with the bed elevated 30-40 degrees; 2) sitting on the edge of the bed with feet supported, arms and head on a padded overbed table; 3) straddling a chair with arms and head resting on the back of the chair.
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| Nursing interventions for a thoracentesis includes exposing the entire chest even though the thoracentesis site is normally in the midclavicular line between the: | second and third intercostal spaces.
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| Nursing observations after a thoracentesis include assessment for: | 1) blood-tinged mucus; 2) signs of hypoxemia; 3) tachycardia.
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| A chest x-ray film is usually ordered after a thoracentesis to rule out: | pneumothorax.
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